Effect of Hospital Ownership on Outcomes of Heart Failure Hospitalization

Akintoye, Emmanuel; Briasoulis, Αlexandros; Egbe, Alexander C.; Orhurhu, Vwaire; Ibrahim, Walid; Kumar, Kartik; Alliu, Samson; Nas, Hala; Levine, Diane; Weinberger, Jarrett

doi:10.1016/j.amjcard.2017.06.009

Cited by 22 publications

(22 citation statements)

References 13 publications

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“…The cost estimates for each comorbidity-related subgroup are presented in ESM 5. The age subgroup analyses showed that the cost of hospitalization was 5–31% higher for patients with HF aged < 65 years than those aged ≥ 65 years [ 62 , 63 , 65 , 67 , 74 , 92 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

et al. 2020

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Background Heart failure presents a growing clinical and economic burden in the USA. Robust cost data on the burden of illness are critical to inform economic evaluations of new therapeutic interventions. Objectives This systematic literature review of heart failure-related costs in the USA aimed to assess the quality of the published evidence and provide a narrative synthesis of current data. Methods Four electronic databases (MEDLINE, EMBASE, EconLit, and the Centre for Reviews and Dissemination York Database, including the NHS Economic Evaluation Database and Health Technology Assessment Database) were searched for journal articles published between January 2014 and March 2020. The review, registered with PROSPERO (CRD42019134201), was restricted to cost-of-illness studies in adults with heart failure events in the USA. Results Eighty-seven studies were included, 41 of which allowed a comparison of cost estimates across studies. The annual median total medical costs for heart failure care were estimated at $24,383 per patient, with heart failure-specific hospitalizations driving costs (median $15,879 per patient). Analyses of subgroups revealed that heart failure-related costs are highly sensitive to individual patient characteristics (such as the presence of comorbidities and age) with large variations even within a subgroup. Additionally, differences in study design and a lack of standardized reporting limited the ability to compare cost estimates. The finding that costs are higher for patients with heart failure with reduced ejection fraction compared with patients with preserved ejection fraction highlights the need for differentiating among different heart failure types. Conclusions The review underpins the conclusion drawn in earlier reviews, namely that hospitalization costs are the key driver of heart failure-related costs. Analyses of subgroups provide a clearer understanding of sources of heterogeneity in cost data. While current cost estimates provide useful indications of economic burden, understanding the nuances of the data is critical to support its application. Electronic supplementary material The online version of this article (10.1007/s40273-020-00952-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

et al. 2020

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“…Differing systemic characteristics among for-profit, not-for-profit, and nonfederal government hospitals have impacted cost and length of stay. 18,19 Our findings indicate that patients treated at privately owned hospitals with traumatic digit amputations were 1.80 times more likely to undergo replantation than those treated at public hospitals. Given the common argument that replantations are insufficiently compensated, this is an interesting finding and suggests reimbursement rates may be less relevant in pediatric digit replantations.…”

Section: Discussionmentioning

confidence: 72%

Effect of Hospital Characteristics on Performance of Pediatric Digit Replantation in the United States

Kleiner

Testa

et al. 2023

Journal of Hand and Microsurgery

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Introduction Utilize a national pediatric database to assess whether hospital characteristics such as location, teaching status, ownership, or size impact the performance of pediatric digit replantation following traumatic digit amputation in the United States. Materials and Methods The Kid’s Inpatient Database (KID) was used to query pediatric traumatic digit amputations between 2000 and 2012. Ownership (private and public), teaching status (teaching and non-teaching), location (urban and rural), hospital type (general and children’s), and size (large and small-medium) characteristics were evaluated. Replantations were then divided into those that required subsequent revision replantation or amputation. Fisher’s exact tests and multivariable logistic regressions were performed with p <0.05 considered statistically significant. Results Overall, 1,015 pediatric patients were included for the digit replantation cohort. Hospitals that were privately owned, general, large, urban, or teaching had a significantly greater number of replantations than small-medium, rural, non-teaching, public, or children’s hospitals. Privately owned (odds ratio [OR]: 1.80; 95% confidence interval [CI]: 1.06–3.06; p = 0.03) and urban (OR: 2.29; 95% CI: 1.41–3.73; p = 0.005) hospitals were significantly more likely to perform replantation. Urban (OR: 4.02; 95% CI: 1.90–8.47; p = 0.0003) and teaching (OR: 2.11; 95% CI: 1.17–3.83; p = 0.014) hospitals were significantly more likely to perform a revision procedure following primary replantation. Conclusion Private and urban hospitals were significantly more likely to perform replantation, but urban and teaching hospitals carried a greater number of revision procedures following replantation. Despite risk of requiring revision, the treatment of pediatric digit amputations in private, urban, and teaching centers provide the greatest likelihood for an attempt at replantation in the pediatric population. The study shows Level of Evidence III.

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“…Their study was based on the systematic review of two decades of articles published since 1980–2003 [ 12 ]. Some of the studies, however, have reported better care quality in for-profit institutions [ 13 – 14 ]. Leleu et al, for instance, have shown reduced readmission in for-profit teaching and fully integrated hospitals than their counterparts [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some of the studies, however, have reported better care quality in for-profit institutions [ 13 – 14 ]. Leleu et al, for instance, have shown reduced readmission in for-profit teaching and fully integrated hospitals than their counterparts [ 13 ]. Akintoye et al, have reported reduced mortality in for-profit hospitals among HF patient from 2013–2014 nationwide [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Notably, non-profit health care institutions have been shown to provide better quality of patient care than for-profit health care institutions in multiple studies [ 8 – 12 ]. Some studies, in contrary, have shown better patient outcomes in for-profit institutions [ 13 , 14 ]. However, little research has been done to report how the ownership structure of hospital operation impacts the readmission rates of the patients in different disease categories.…”

Section: Introductionmentioning

confidence: 99%

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Proprietary management and higher readmission rates: A correlation

et al. 2018

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IntroductionReducing preventable readmissions among Medicare beneficiaries is an effective way to not only reduce the exorbitantly rising cost in healthcare but also as a measure to improve the quality of patient care. Many of the previous efforts in reducing readmission rate of patients have not been very successful because of ill-defined quality measures, improper data collection methods and lack of effective strategies based on data driven solutions.MethodsIn this study, we analyzed the readmission data of patients for six major diseases including acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), pneumonia (PN), chronic obstructive pulmonary disease (COPD), and total hip arthroplasty and/or total knee arthroplasty (THA/TKA) from the Center for Medicare and Medicaid Readmissions Reduction Program (HRRP) program for the period 2012–2015 in context with the ownership structure of the hospitals.ResultsOur analysis demonstrates that the readmission rates of patients were statistically higher in proprietary (for profit) hospitals compared to the government and non-profit hospitals which was independent of their geographical distribution across all six major diseases.ConclusionThis finding we believe has strong implications for policy makers to mitigate any potential risks in the quality of patient care arising from unintended revenue pressure in healthcare institutions.

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Effect of Hospital Ownership on Outcomes of Heart Failure Hospitalization

Cited by 22 publications

References 13 publications

A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014–2020)

Effect of Hospital Characteristics on Performance of Pediatric Digit Replantation in the United States

Proprietary management and higher readmission rates: A correlation

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